Can IT Cure Healthcare's Inertia?

If the industry remains resistant to change, it will eventually render itself obsolete.

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Perhaps you've seen the TV commercial for a popular arthritis drug that says, "A body at rest tends to stay at rest, while a body in motion tends to stay in motion." The ad refers, of course, to a law of physics called inertia--which brings to mind the U.S. healthcare system.

Our arthritic system certainly suffers from an unwillingness to move forward. It stubbornly clings to a fee-for-service model, focuses most of its energy on treatment rather than prevention, and resists IT innovations that can transform it into a nimble, cost-effective business.

And speaking of business models, the U.S. medical system has fallen victim to the same kind of myopia that recently bankrupted Kodak and seriously weakened the railroad industry over the years.

In January 2012, Kodak filed for Chapter 11, and as David Asch and colleagues from the Philadelphia VA Medical Center point out, the company's demise was largely the result of not understanding what kind of business it was in--at least from its customers' point of view.

In last week's New England Journal of Medicine, Asch and associates point out that "Kodak was late to recognize that it was not in the film and camera business: it was in the imaging business." And when the public found a better way to get their images, namely through digital services, it was too late for Kodak to catch up.

The railroad industry has suffered from the same shortsightedness, imagining that it's in the train business when in fact it's in the transport business. And that mistake has cost it dearly, allowing competitors with cars, trucks, and planes to make major inroads into its business (no pun intended).

Healthcare could be driving down this same dead-end street, imagining it's in the healthcare industry while what customers really want isn't healthcare but health. "Healthcare is just a means to an end--and an increasingly expensive one. If we could get better health some other way ... then maybe we wouldn't have to rely so much on healthcare," Asch said.

There are alternative ways to better health, and many of these options make use of information technology. Patients' alternative path typically starts off by doing an Internet search to understand their symptoms and the standard treatments for a specific disorder. They then shop online for the best approach to their condition, which sometimes takes advantage of the orthodox healthcare system and sometimes takes them to chiropractors, nutritionists, massage therapists, acupuncturists, hypnotists, and other less conventional practitioners.

Other patients are turning to their smartphones to see what their options are within the traditional healthcare system. Castlight Health, for instance, provides an online shopping platform for healthcare. Castlight says it lets consumers "see their options for selecting a doctor or choosing a lab or clinic, complete with cost and quality of care information, before they make an appointment." The company recently introduced a mobile app that lets consumers use their phones to access pricing and quality data.

We're always going to need hospitals, surgeons, and prescription medication to manage life-threatening illness, but patients increasingly are turning away from the mainstream healthcare system to manage chronic disorders. To remain relevant, clinicians need to get deeply involved in the patient engagement business, and use all the relevant IT tools now available.

Patient portals, secure email systems, and online patient education libraries are a significant part of this effort. Some hospitals are even setting up what's best described as "internal Facebook" systems that let patients share experiences and support one another.

Patients and their parents at Children's also have access to a patient portal, called MyChart, where they can see test results, a list of medications, and alerts for appointments. They can request prescription refills, make appointments, interact with clinical staff through a HIPAA-compliant email system, and get information about insurance coverage.

To stay relevant in any industry, managers have to think the way their customers do, whether they process photos, move freight across the country, or remove gallbladders. Inertia simply isn't an option.

InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital CIO Roundtable issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.)

You're absolutely right. Many healthcare groups have forgotten that there is a business side to healthcare which includes being competitive and customer service. Patients seem to be seeking treatment more and more outside the traditional setting. It'll be interesting to see how IT changes things.Jay SimmonsInformation Week Contributor